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General NPI Number Information
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NPI Number | 1316091200
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Entity Type | Organization
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Legal Business Name | PEGASUS SCHOOLS, INC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/07/2020
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Provider Practice Location Address
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Address Line | 896 ROBIN RANCH RD
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City | LOCKHART
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State | TX
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Zip | 78644-4578
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Country | US
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Telephone | 512-376-2101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 577
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City | LOCKHART
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State | TX
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Zip | 78644-0577
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Country | US
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Telephone | 512-376-2101
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Fax |
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | ROBERTA SMITH
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Credential |
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Telephone | 512-432-1602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 844396
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 844396
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License Number State | TX
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